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The first edition of Leg Ulcers by David Negus was published in 1991. Since then, developments in the management of venous disorders and, in particular, of venous ulceration, have continued apace. Prominent among these has been the development of duplex ultrasound scanning, which now enables the diagnosis and treatment of venous ulceration to be undertaken with a sound knowledge of the underlying anatomy. Treatment options now include PIN stripping of the long saphenous vein, endoscopic perforating vein interruption and ultrasound-guided foam sclerotherapy. All of these developments, and more, are covered in this comprehensive guide to the management of this unpleasant and often socially una...
Painful and sustained muscle contractions that occur in the lower limbs.
Causes of leg oedema that require prompt treatment must be identified, e.g. deep vein thrombosis and heart failure. The most common cause of leg oedema in patients over 50 years of age is insufficiency of the leg veins. Oedema caused by insufficiency of the deep leg veins can be treated with compression therapy (graduated compression stockings). In women under the age of 50 years, the most likely cause is idiopathic oedema and non-drug therapy is the first-line treatment approach. Oedema caused by medication (particularly calcium-channel blockers) must be recognised. Excessive use of diuretics must be avoided when oedema results from immobilisation, venous stasis or an obstruction to the lymph flow. In many cases, oedema is caused by a multitude of factors.